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Eccentric treatment for patellar tendinopathy: a prospective randomised short-term pilot study of two rehabilitation protocols
  1. Anna Frohm1,
  2. Tönu Saartok1,
  3. Kjartan Halvorsen2,
  4. Per Renström1
  1. 1Department of Molecular Medicine and Surgery, Section of Orthopedics and Sports Medicine & Stockholm Sport Trauma Research Center, Karolinska Institutet, Stockholm, Sweden
  2. 2Biomechanics and Motor Control Laboratory, Department of Sport and Health Sciences, Swedish School of Sport and Health Sciences, Stockholm, Sweden; Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to:
 Dr A Frohm
 Department of Molecular Medicine and Surgery, Section of Orthopedics and Sports Medicine, Karolinska Institutet M:3, SE-171 76 Stockholm, Sweden; anna.frohm{at}telia.com

Abstract

Objective: To compare the efficacy and safety of two eccentric rehabilitation protocols for patients with symptomatic patellar tendinopathy. A new eccentric overload training device was compared with the present standard eccentric rehabilitation programme on a decline board.

Design: Prospective, randomised clinical trial.

Setting: Sports rehabilitation clinic, university sports laboratory, supplemented with home exercises.

Patients: 20 competitive and recreational athletes, all with clinical diagnosis of patellar tendinopathy, verified by MRI or ultrasound imaging.

Interventions: A 12-week rehabilitation period, either with bilateral eccentric overload strength training using the Bromsman device twice a week or with unilateral eccentric body load training using a decline board twice a week, supplemented with daily home exercises.

Outcome measures: The primary outcome was pain and function, assessed by the Swedish Victorian Institute of Sport Assessment for Patella (VISA-P) score. Secondary outcome measures were isokinetic muscle torque, dynamic function and muscle flexibility, as well as pain level estimations using visual analogue scale (VAS). Side effects were registered.

Results: Both treatment groups improved in the short term according to the VISA-P scores during the 12-week rehabilitation period. However, there were no significant differences between the groups in terms of pain and function. After a 3-month rehabilitation period, most patients could be regarded as improved enough to be able to return to training and sports. No serious side effects were detected in either group.

Conclusion: In patients with patellar tendinopathy pain, two-legged eccentric overload training twice per week, using the new device (Bromsman), was as efficient and safe as the present standard daily eccentric one-legged rehabilitation-training regimen using a decline board.

  • CMJ, counter movement jumps
  • GEE, generalised estimating equations
  • IST, isokinetic strength testing
  • VAS, visual analogue scale
  • VISA-P, Victorian Institute of Sport Assessment for Patella
  • US, ultrasonography

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Footnotes

  • Published Online First 9 February 2007

  • Competing interests: None.

  • Written consent was obtained from patients to publish their photos in this study.

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